Circulating levels of cytokines during pregnancy: thrombopoietin is elevated in miscarriage

Objective

To evaluate the hypothesis that cytokine levels are associated with miscarriage risk using serum samples collected before report of miscarriage.

Design

A nested case-control study.

Setting

Biospecimens from the multisite Collaborative Perinatal Project, University of Florida, laboratory assessment of interleukin (IL)-1 receptor antagonist, IL-1β, IL-4, IL-6, interferon (IFN)-γ, tumor necrosis factor (TNF)-α, thrombopoietin (TPO), and granulocyte colony-stimulating factor (G-CSF).

Patient(s)

Cases of miscarriage (n = 439) were matched to controls (n = 373) by gestational age at sample collection.

Intervention(s)

None.

Main Outcome Measure(s)

Miscarriage.

Result(s)

Increased risk of miscarriage was associated with elevated TPO (adjusted odds ratio [OR] 1.16, 95% confidence interval [CI] 1.00–1.36) and decreased G-CSF (adjusted OR 0.78, 95% CI 0.64–0.95). When analysis was restricted to samples collected more than 35 days before miscarriage, the effect of G-CSF was not observed (adjusted OR 0.96, 95% CI 0.72–1.28), whereas increased risk related to higher TPO remained.

Conclusion(s)

Circulating levels of TPO may be associated with increased risk of miscarriage.

Key Words: Cytokines, epidemiology, hematopoiesis, miscarriage, placentation